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US20090125067A1 - In-line occipital plate and method of use - Google Patents

In-line occipital plate and method of use Download PDF

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Publication number
US20090125067A1
US20090125067A1 US11/936,904 US93690407A US2009125067A1 US 20090125067 A1 US20090125067 A1 US 20090125067A1 US 93690407 A US93690407 A US 93690407A US 2009125067 A1 US2009125067 A1 US 2009125067A1
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United States
Prior art keywords
coupling element
elongate member
plate
center
line
Prior art date
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Abandoned
Application number
US11/936,904
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English (en)
Inventor
Michael J. Mazzuca
Connie P. Marchek
Michael D. Sorrenti
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DePuy Spine LLC
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DePuy Spine LLC
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by DePuy Spine LLC filed Critical DePuy Spine LLC
Priority to US11/936,904 priority Critical patent/US20090125067A1/en
Assigned to DEPUY SPINE, INC. reassignment DEPUY SPINE, INC. ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: MARCHEK, CONNIE P., MAZZUCA, MICHAEL J., SORRENTI, MICHAEL D.
Priority to PCT/US2008/080438 priority patent/WO2009061604A1/fr
Publication of US20090125067A1 publication Critical patent/US20090125067A1/en
Abandoned legal-status Critical Current

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/70—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant
    • A61B17/7055—Spinal positioners or stabilisers, e.g. stabilisers comprising fluid filler in an implant connected to sacrum, pelvis or skull
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips

Definitions

  • the present disclosure relates to devices and methods for use in various spinal fixation procedures, and in particular to devices and methods for use in cervical stabilization procedures.
  • Stabilization of the spine is often required following trauma, tumor, or degenerative pathologies. Although each region of the spine presents unique clinical challenges, posterior fixation of the cervical spine is particularly challenging because the anatomy of the cervical spine makes it a technically difficult area to instrument. Specifically, several vital neural and vascular structures, including the vertebral arteries, nerve roots, and spinal cord must be avoided during surgery.
  • fixation rods are coupled to adjacent vertebrae by attachment to various anchoring devices, such as hooks, bolts, wires, or screws. Often, two rods are disposed on opposite sides of the spinous process in a substantially parallel relationship.
  • the fixation elements can have a predetermined contour that has been designed according to the properties of the target implantation site, and once installed, the fixation elements hold the vertebrae in a desired spatial relationship, either until healing or spinal fusion has taken place, or for some longer period of time.
  • the proximal ends of the rods are typically molded according to the anatomy of the skull and the cervical spine, and attached to a fixation plate that is implanted in the occiput.
  • a single occipital plate (e.g., a T-shaped or Y-shaped plate) is positioned along the midline of a patient's occipital bone so that the single plate can engage adjacent spinal fixation elements that run on either side of the midline.
  • the surgeon must select a position capable of accommodating both the first and second fixation elements.
  • it is often difficult to engage the fixation element(s) to such a fixation plate once the fixation plate is engaged to the desired anatomical location.
  • some procedures utilize a one-piece design (i.e., the fixation element engaged to the fixation plate prior to use).
  • fixation element engaged to the fixation plate prior to use
  • such devices can be difficult to use in that they can limit the surgeon's ability to select the optimal engagement point on the occipital bone and/or the vertebrae.
  • use of such mid-line plates can also be limited by the patient's anatomy. For example, some patients, either from a previous surgical procedure or from natural causes, have an enlarged foramen magnum thereby eliminating the possibility of using any type of mid-line fixation plate.
  • Devices and methods for enhancing the effectiveness of spinal fixation surgery are provided herein.
  • the devices and methods described below provide a surgeon with the ability to optimize the selection of an engagement point for a spinal fixation element relative to a patient's occipital bone.
  • the surgeon is now free to weigh variables such as bone thickness and/or bone density, size/shape of the patient's foramen magnum, etc. without the burden of selecting a location suitable for both first and second fixation elements (e.g., rods) and/or the exact orientation of the fixation element relative to the fixation plate.
  • first and second fixation elements e.g., rods
  • the devices and methods allow the surgeon to engage a fixation plate at an optimal location of the occipital bone, position a spinal fixation element along a series of vertebrae, manipulate a coupling element of the fixation plate so as to align the coupling element with the superior end of the fixation element, and securely engage the fixation element to the coupling element.
  • this flexibility provides enhanced stability, effectiveness, and usefulness for such spinal stabilization procedures.
  • the device can include an elongate member having a first end and a second end with a center-line extending therebetween.
  • the center-line can be straight, curved, etc.
  • the device can include any number of bone screw receiving thru-hole(s) (e.g., 1, 2, 3, 4, etc.) formed in the elongate member thereby allowing the device to be secured to the desired anatomical location.
  • the thru-holes are positioned proximate the center-line of the elongate member.
  • the thru-holes can be positioned along the center line or at least one thru-hole can be positioned offset from the center line (e.g., the holes can be staggered along the center line).
  • the length and/or width of the elongate member can be configured to optimize the given procedure.
  • the elongate member can also be formed of a wide range of biocompatible materials (e.g., various polymers, polymer blends, metals, etc.). In an exemplary embodiment, the elongate member can be configured to conform to the surface of a target anatomical location.
  • the device can further include a position-adjustable coupling element configured to releasably engage a spinal fixation element formed on or engaged to a location proximate (e.g., aligned with or off-set from) the center-line of the elongate member.
  • the coupling element is rotatable and is in alignment with the thru-hole(s).
  • the coupling element can be any element capable of releasably engaging a fixation element to the elongate member.
  • the coupling element can include a substantially “U-shaped” opening having a central channel configured to receive the spinal fixation element.
  • the coupling element can be a slotted bolt.
  • the coupling element can be formed on and/or engaged to the elongate member in any number of manners.
  • the coupling element can be engaged to a thru-hole (e.g., an elongate thru-hole) in the elongate member.
  • the coupling element can be positioned at various locations of the elongate member.
  • the coupling element can be positioned substantially in the middle of the elongate member, at an inferior portion of the elongate member, etc.
  • the coupling element can be formed on or engaged to the elongate member in any number of ways and at varying positions relative to the elongate member so as to optimize the efficiency and resulting stability of the fixation procedure.
  • the coupling element can be configured in various ways so as to facilitate engagement of a fixation element to the device.
  • the coupling element in addition to being rotatable, can be translatable and/or be capable of polyaxial movement relative to the elongate member.
  • such rotatable, translatable, and/or polyaxial movement of the coupling element relative to the elongate member can be provided in any number of ways.
  • an in-line occipital plate which includes an elongate plate member with a center-line (straight or curved) extending from a first end of the member to a second end of the member wherein the elongate plate member is conformable to an anatomical location.
  • the elongate member can include a single position-adjustable coupling element configured to releasably engage a single spinal fixation element, and the member can further include at least one bone screw receiving thru-hole.
  • the rotatable coupling element and the bone screw receiving thru-hole(s) are positioned proximate the center-line of the elongate member.
  • the coupling element can be translatable along the center-line of the elongate member.
  • the coupling element can be configured for polyaxial movement relative to the elongate member.
  • an implantable spinal fixation device which includes an occipital plate having a first end, a second end, and a center-line extending therebetween.
  • the occipital plate can include a plurality of bend zones to accommodate a location adjacent a midline of a patient's occipital bone.
  • the spinal fixation device can include a plurality of thru-holes proximate the center-line of the occipital plate.
  • the occipital plate includes a single position adjustable (e.g., rotatable and/or translatable) coupling element positioned within an elongate thru-hole.
  • the coupling element can include a U-shaped opening having a central channel. Similar to above, the coupling element can also be configured for polyaxial movement relative to the elongate member.
  • the system includes an embodiment of a presently provided occipital plate connected to an occiput, a bone anchor (one or a plurality of such anchors) implanted in a vertebra(e), and a spinal fixation element connecting the bone anchor(s) and the occipital plate.
  • the method includes fixing an inferior portion of a spinal fixation element to one or more vertebrae.
  • the method also includes providing an occipital plate having a superior end and an inferior end and a plurality of bone screw receiving thru-holes positioned proximate the center-line of the occipital plate.
  • the plate can include a position adjustable (e.g., rotatable) coupling element substantially aligned with (or offset from) the center-line of the occipital plate.
  • the method further includes fixing the occipital plate to an anatomical location which is adjacent the foramen magnum and offset from an axis defined by the spinal column, and fixing a superior portion of the spinal fixation element to the rotatable coupling element of the plate.
  • the method can include coupling a second fixation element to a second occipital plate thereby allowing for first and second fixation elements to be positioned on opposite sides of the patient's spinal column.
  • the method can also include various steps for manipulating the coupling element relative to the superior end of the fixation element so as to align the coupling element with the fixation element thereby facilitating fixation.
  • the method can include rotating, translating and/or polyaxially adjusting the coupling element relative to the occipital plate so as to align the coupling with the superior portion of the spinal fixation element.
  • the method can include positioning first and second fixation elements on opposite sides of a patient's spinal column (e.g., along opposite sides of the midline of the spinal column).
  • the method can include fixing (e.g., via bone anchors) first and second spinal fixation elements to at least one vertebra.
  • the method can also include providing first and second occipital plates.
  • each occipital plate can have a first end, a second end and a center-line extending therebetween.
  • the plates can also include a plurality of thru-holes positioned proximate the center-line, and a single position adjustable (e.g., rotatable and/or translatable) coupling element positioned within an elongate thru-hole.
  • the method can further include fixing the first occipital plate adjacent the foramen magnum and offset in a first lateral direction from an axis defined by the spinal column, and fixing the second occipital plate adjacent the foramen magnum and offset in a second lateral direction from an axis defined by the spinal column.
  • the method can further include manipulating the coupling element(s) relative to the first and second occipital plates so as to align each coupling element with the superior portion of a corresponding spinal fixation element.
  • the method can include fixing a superior portion of the first and second spinal fixation elements to the first and second position adjustable couplings.
  • the method can include conforming the first and second occipital plates to an anatomical location adjacent the foramen magnum and offset from an axis defined by the spinal column.
  • FIG. 1 is a perspective view of a prior art spinal fixation system
  • FIG. 2A is a perspective view of an embodiment of first and a second spinal fixation devices engaged at desired anatomical locations;
  • FIG. 2B is an alternative view of the spinal fixation devices of FIG. 2A ;
  • FIG. 3A is a perspective view of an exemplary embodiment of a spinal fixation device
  • FIG. 3B is an exploded view of the device of FIG. 3A ;
  • FIG. 4A is a perspective view of another exemplary embodiment of an occipital plate
  • FIG. 4B is a perspective view of another exemplary embodiment of an occipital plate
  • FIG. 5A is another exemplary embodiment of a spinal fixation device.
  • FIG. 5B is an exploded view of the device of FIG. 4A .
  • the presently disclosed embodiments provide a surgeon with the ability to engage a fixation element to an optimal location of the patient's anatomy without being limited to a location along the midline of a patient's spinal column and/or without being limited with respect to the exact orientation of a fixation element(s) (e.g., the fixation rod) to be engaged by the fixation plate.
  • the fixation plates provided herein include an elongate, generally planar fixation plate which can be configured for placement at any desired anatomical location.
  • the plate can be configured so as to include a series of bone screw receiving thru-hole(s) positioned proximate a center-line of the elongate plate.
  • the thru-holes can be positioned along the center-line or the thru-holes can be positioned such that at least one thru-hole is off-set from the center line.
  • the plate can include a position-adjustable coupling element configured to engage a fixation element wherein the coupling element can also be positioned proximate the center-line.
  • the presently disclosed devices and methods allow for increased versatility in that the coupling element for the fixation element can be rotatable, translatable, and/or capable of polyaxial movement relative to the elongate member thus allowing the coupling element to be easily aligned with a superior end of a fixation element.
  • Such versatility allows the fixation device to be positioned independent of the exact orientation of the fixation rod.
  • the devices and methods provided herein allow a surgeon to engage a fixation plate at an optimal location of the occipital bone, position a spinal fixation element along a series of vertebrae, manipulate a coupling element so as to align the coupling element with the superior end of the fixation element, and securely engage the fixation element to the coupling element.
  • FIG. 1 shows a commonly used technique in which a prior art occipital plate 13 is fixed along the midline (M.L.) of a patient's occipital bone 11 .
  • the procedure typically requires a first plurality of fixation assemblies 17 (e.g., a bone-anchor coupled to a receiving head) engaged to a plurality of vertebrae V 1 , V 2 , V 3 , V 4 , V 5 , V 6 along one side of the midline (M.L.) of the patient's spinal column, and a second plurality of fixation assemblies 17 ′ along an opposite side of the midline (M.L.).
  • fixation assemblies 17 e.g., a bone-anchor coupled to a receiving head
  • a first fixation element 15 can be engaged to the first plurality of fixation assemblies 17
  • a second fixation element 15 ′ can be engaged to the second plurality of fixation assemblies 17 ′.
  • a superior portion 17 s, 17 s ′ of each fixation assembly 17 , 17 ′ can be engaged to various coupling elements 13 ′, 13 ′′ fixed to the occipital plate 13 .
  • the surgeon is required to position the plate 13 along the midline (M.L.) of the occipital bone 11 in order to ensure that both the first and second fixation elements 15 , 15 ′ can be engaged to the same plate 13 .
  • a drawback to such an approach is that the surgeon cannot select the optimal bone location for each fixation assembly, and must instead utilize a location accessible to both fixation elements 15 , 15 ′.
  • FIGS. 2A-2B illustrate a stabilization procedure performed with exemplary embodiments of the presently disclosed occipital plate(s) 10 , 10 ′.
  • the occipital plates 10 , 10 ′ can be engaged to the patient's occipital bone 11 in any position and/or in any orientation as desired by the surgeon.
  • each occipital plate 10 can be configured as an elongate plate capable of conforming to an anatomical location adjacent the midline (M.L) of a patient's occipital bone 11 . Further, since each occipital plate 10 , 10 ′ is configured to releasably engage only a single fixation element 15 , 15 ′, the plates 10 , 10 ′ can be engaged to the occipital bone 11 independent of one another thereby adding to the versatility of the procedure.
  • the ability to independently position the plates 10 , 10 ′ adjacent the midline (M.L.) of the patient's spinal column provides significant advantages to those procedures where the patient has an oversized foramen magnum which renders it impossible for the surgeon to position any type of plate along the midline (M.L.) of the patient's occipital bone 11 .
  • FIGS. 3A-3B provide an exemplary embodiment of the presently disclosed in-line occipital plate 10 .
  • the occipital plate 10 can include a generally elongate member 12 that defines a center-line (L) extending between inferior and superior ends 12 a, 12 b thereof.
  • the center line (L′) can also be curved.
  • the shape of the elongate member 12 can vary, but in an exemplary embodiment the elongate member 12 can be substantially planar wherein the inferior and superior ends 12 a, 12 b have a rounded or convex profile to avoid the risk of damage during implantation. In other embodiments, as shown in FIG. 4A , the elongate member can be curved.
  • the plate 10 can be generally planar in an initial configuration, it is understood that a surgeon can contour the plate to conform to the area of implantation. Alternatively, the plate 10 may be contoured.
  • the length (l) and width (w) of the elongate member 12 can also vary, and will typically depend on the nature of the procedure and/or the patient's anatomy.
  • the elongate member 12 can have a substantially constant width (w) from the first end 12 a to the second end 12 b of the plate 10 .
  • the length (l) of the plate 10 can range from about 30 mm to about 50 mm
  • the width (w) of the plate 10 can range from about 8 mm to about 15 mm.
  • the occipital plate 10 can also include any number (e.g., 1, 2, 3, 4, 5, etc.) of bone screw receiving thru-holes configured to receive a corresponding number of bone screws (not shown) or any another type of suitable anchoring devices so as to anchor the plate 10 to the underlying occipital bone 11 .
  • the exemplary embodiment of FIG. 3A includes three such bone screw receiving thru-holes 16 , 18 , 20 .
  • the bone-screw receiving thru-holes 16 , 18 , 20 can be of any shape (e.g., circular, oval, etc.) and/or diameter capable of securely receiving the bone screw or other suitable anchoring device.
  • the thru-holes 16 , 18 , 20 can be substantially similar in shape (as shown) or they can each have a distinct shape(s) and/or diameter(s).
  • the alignment and/or positioning of the thru-holes 16 , 18 , 20 relative to the elongate member 12 can also be optimized to conform to the desired anatomical location.
  • the thru-holes 16 , 18 , 20 can be substantially aligned or positioned proximate along the center line (L) of the elongate member 12 thereby providing optimal stability for positioning of the occipital plate 12 at a location adjacent the midline of the patient's spine. For example, as shown in FIG.
  • the thru-holes 16 , 18 , 20 can be aligned along the center-line (L).
  • the thru-holes 16 , 18 , 20 (or at least one thereof) can be positioned offset from the center-line.
  • the holes 16 , 18 , 20 can be staggered along a length of the plate.
  • the occipital plate 10 can include a coupling element 30 capable of releasably engaging a fixation element ( 15 , see FIGS. 2A-2B ).
  • the coupling element 30 can also be positioned proximate the center-line (L) of the plate 10 , further optimizing the plate's ability to conform to a location adjacent the midline of the spinal column.
  • the various embodiments of the presently disclosed occipital plate 10 include a position-adjustable coupling element 30 configured to releasably engage a single fixation element thereby providing several advantages over commonly used devices. More specifically, the ability to engage only a single fixation element allows the surgeon to engage the occipital plate 10 to an anatomical location without concern as to the relative positioning of a second fixation element. Also, the ability to releasably engage the fixation element allows the surgeon to first select the optimal location and then securely engage the fixation element thereto. Thus, the surgeon is not restrained by finding a location which accommodates the fixation element already engaged to the occipital plate.
  • the coupling element 30 can be configured to be rotatable, translatable, and/or capable of polyaxial movement relative to the elongate member 12 of the plate thereby facilitating the surgeon's ability to engage the fixation element to the coupling element 30 .
  • the coupling element 30 can be any element capable of releasably engaging a spinal fixation element to the elongate member 12 . More specifically, the coupling element 30 can be a cylinder-like object 32 having a U-shaped opening formed therein which is configured to receive the fixation element. In an exemplary embodiment, the coupling element 30 can be a slotted bolt.
  • the coupling element 30 can be engaged to and/or formed on the elongate member 12 at a location proximate (e.g., in alignment with or offset from) the center-line in any number of ways.
  • the coupling element 30 can be secured to the elongate member 12 via a thru-hole 14 formed in the member 14 .
  • an engagement ring 34 can be placed over the coupling element 30 and secured to the element 30 via a groove 32 ′ formed therein.
  • a fixation element can be positioned within the U-shaped opening and secured using a set screw 21 ( FIGS. 2A and 2B ) or any other suitable closure element.
  • the inner portion of the U-shaped opening can include a series of threads 33 adapted to engage a corresponding series of threads (not shown) formed in the set screw 21 thereby securing the fixation element within the coupling element 30 .
  • the coupling element 30 can be manipulated relative to the elongate member 12 in various ways thereby facilitating engagement of the fixation element thereto. More specifically, the ability to manipulate the coupling element 30 relative to the elongate member 12 allows the surgeon to engage the plate 10 to an optimal anatomical location and then further manipulate the coupling element 30 so as to align the coupling element 30 with the fixation element 15 (see FIGS. 2A and 2B ). Manipulation of the position adjustable coupling element 30 relative to the elongate member 12 can allow for various ranges of motion of the element 30 relative to the plate 12 .
  • the coupling element 30 can be configured to be rotatable relative to the elongate member 12 thereby allowing the U-shaped opening to be rotated after the elongate plate 12 is engaged to the occipital bone 11 .
  • Various embodiments can allow for various degrees of rotation.
  • the coupling element 30 can be configured to rotate in only one direction (e.g., clockwise) or both directions (clockwise and counter-clockwise).
  • the coupling element 30 can be configured to rotate a limited amount (e.g., about 45 degrees) or the coupling element 30 can be configured to rotate 360 degrees.
  • the coupling element 30 can be engaged to the elongate member 12 in a variety of manners so as to provide the desired rotation.
  • the substantially cylindrical shape of the coupling element 30 can allow for the coupling element 30 to rotate relative to the opening 14 of the elongate member 12 .
  • the coupling element 30 can be configured to be translatable relative to the elongate member 12 .
  • the ability to translate the coupling element 30 along the elongate member 12 further facilitates the surgeon's ability to align the coupling element 30 with the fixation element.
  • the coupling element 30 can be engaged to the elongate member 12 in any number of ways so as to provide such translatable movement.
  • the coupling element 30 can be disposed within an elongated thru-hole 14 thereby allowing the coupling element 30 to move laterally along the opening 14 .
  • the length of the opening (L o ) can vary depending on the requirements of the procedure and/or the patient's anatomy.
  • the coupling element 30 can also be configured to be capable of polyaxial movement relative to the elongate member 12 .
  • the coupling element 30 can be engaged to the elongate member 12 in various ways to provide such polyaxial movement.
  • the groove 32 ′ of the coupling element 30 can have a semi-cylindrical shape.
  • a bottom portion of the groove 32 ′, the top and bottom surfaces of the elongate member 12 , and a bottom portion of the washer 34 can also include mating cylindrical surfaces thereby allowing for polyaxial movement when the element 30 is coupled to the opening 14 of the elongate member 12 .
  • the occipital plate 10 can be configured to adapt and/or conform to a target anatomical location (e.g., adjacent the midline of a patient's spinal column).
  • a target anatomical location e.g., adjacent the midline of a patient's spinal column.
  • the occipital plate 10 can be configured as such in a variety of manners.
  • the occipital plate 10 can be formed of a flexible or malleable material thereby allowing for the plate 10 to bend and accommodate the target anatomical location.
  • the spinal fixation plate 10 can include at least one bend zone 36 formed therein for allowing the elongate member 12 to conform the plate to a surface of the target anatomical location.
  • the bend zones 36 can be formed from grooves or channels that extend across at least one of the front surface 36 a or the back surface 36 b of the elongate member 12 .
  • Those skilled in the art will appreciate that a variety of other techniques can be used to provide bendable movement of one or more portions of the spinal fixation plate 10 , and that the bend zones can be formed at any location along the elongate member 12 .
  • FIGS. 5A-5B provide another exemplary embodiment of the fixation plate 100 in which the coupling element 30 is positioned substantially in the middle of the elongate member 12 .
  • the fixation plate 100 can include a first plurality of bone screw receiving thru-holes 52 , 54 positioned on one side of the coupling element 30 and additional bone-screw receiving thru-holes 56 , 58 on the opposite side of the coupling element 30 .
  • the thru-holes 52 , 54 , 56 , 58 and the coupling element 30 can all be positioned proximate the center-line (L) of the elongate member 12 of the plate 100 .
  • Such a configuration can allow the plate 100 to be positioned adjacent the midline (M.L.) of the patient's spinal column.
  • the coupling element 30 can be engaged to the fixation plate 100 via a thru-hole 60 disposed in the plate 100 .
  • the coupling element 30 can be configured to be rotatable, translatable, and/or configured for polyaxial movement relative to the elongate member 12 .
  • the occipital plate can include any number and/or orientation of thru-hole(s) and/or the coupling element can be positioned at any location relative to the elongate member 12 (e.g., middle, inferior end, etc.).
  • the method includes fixing an inferior portion of a spinal fixation element to one or more vertebrae and further providing an occipital plate of the types described above and illustrated in FIGS. 3A-5B capable of releasably engaging a portion of the fixation element.
  • the method further includes fixing the occipital plate to a desired anatomical location.
  • a desired anatomical location is a location adjacent the foramen magnum and offset from an axis defined by the spinal column where there is a sufficient quantity of healthy bone in which to anchor the plate.
  • positioning the plate adjacent the foramen magnum is particularly useful in those procedures where the patient has an enlarged foramen magnum.
  • the method can further include positioning a first fixation plate 10 along one side of the midline of the patient's spine, and positioning a second fixation plate 10 ′ on the opposite side of the midline of the patient's spinal column thereby allowing for first and second fixation elements 15 , 15 ′ to be positioned on opposite sides on the midline of the spinal column.
  • biocompatible materials include, by way of non-limiting example, composite materials, polymeric materials, biocompatible metals and alloys such as stainless steel, titanium, titanium alloys and cobalt-chromium alloys, and any other material that is biologically compatible and non-toxic to the human body.

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Cited By (20)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US20100082067A1 (en) * 2008-09-29 2010-04-01 Kondrashov Dimitriy G System and method to stablize a spinal column including a spinolaminar locking plate
US20110106085A1 (en) * 2009-10-30 2011-05-05 Warsaw Orthopedic, Inc. Adjustable occipital vertebral fixation system
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US9962192B2 (en) 2016-03-17 2018-05-08 Medos International Sarl Multipoint fixation implants
WO2017161218A3 (fr) * 2016-03-17 2017-11-02 Medos International Sarl Implants à fixation multipoint
CN109475371A (zh) * 2016-03-17 2019-03-15 美多斯国际有限公司 多点固定植入物
US11154332B2 (en) 2016-03-17 2021-10-26 Medos International Sarl Multipoint fixation implants
US12376888B2 (en) 2016-03-17 2025-08-05 Medos International Sàrl Multipoint fixation implants
US10779861B2 (en) 2016-03-17 2020-09-22 Medos International Sarl Multipoint fixation implants
US11974784B2 (en) 2016-03-17 2024-05-07 Medos International Sàrl Multipoint fixation implants
US12144529B2 (en) 2018-03-02 2024-11-19 Stryker European Operations Limited Bone plates and associated screws
US11039865B2 (en) 2018-03-02 2021-06-22 Stryker European Operations Limited Bone plates and associated screws
US10898232B2 (en) 2018-03-20 2021-01-26 Medos International Sàrl Multipoint fixation implants and related methods
US11717327B2 (en) 2018-03-20 2023-08-08 Medos International Sarl Multipoint fixation implants and related methods
US12256962B2 (en) 2018-03-20 2025-03-25 Medos International Srl Multipoint fixation implants and related methods
US11998248B2 (en) 2019-09-25 2024-06-04 Medos International Sårl Multipoint angled fixation implants for multiple screws and related methods
US11426210B2 (en) 2019-09-25 2022-08-30 Medos International Sàrl Multipoint angled fixation implants for multiple screws and related methods
US11324538B2 (en) 2019-12-04 2022-05-10 Biomet Manufacturing, Llc Active bone plate
US12185980B2 (en) 2020-02-14 2025-01-07 Medos International Sàrl Integrated multipoint fixation screw
US11304728B2 (en) 2020-02-14 2022-04-19 Medos International Sarl Integrated multipoint fixation screw
US11950811B2 (en) 2020-09-22 2024-04-09 Alphatec Spine, Inc. Occipital plates and related methods
US12303172B2 (en) 2020-09-22 2025-05-20 Alphatec Spine, Inc. Occipital plates and related methods

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